孤独症谱系障碍患儿血清5-HT、SF水平与病情严重程度的相关性研究  

Correlations between serum 5-HT and SF levels and the severity of illness in children with autism spectrum disorder

作　　者：魏向倩 曹丽佳 李妥 李玲歆 WEI Xiangqian;CAO Lijia;LI Tuo(The Sixth Hospital of Shijiazhuang,Shijiazhuang 050000,China)

机构地区：[1]石家庄市第六医院,河北石家庄050000 [2]河北省盐山县人民医院

出　　处：《精神医学杂志》2024年第5期460-464,共5页Journal of Psychiatry

基　　金：河北省2024年度医学科学研究课题计划(编号:20242140)。

摘　　要：目的分析孤独症谱系障碍(ASD)患儿血清5-羟色胺(5-HT)及血清铁蛋白(SF)水平及与病情严重程度的相关性。方法选取ASD患儿82例作为研究组,选取同期体检的34名健康儿童作为对照组,根据儿童期孤独症评定量表(CARS)评分对82例不同病情严重程度ASD患儿进行分组,分为轻中度组(30~35分)45例和重度组(≥36分)37例。使用酶联免疫吸附法(ELISA)检测两组血清5-HT、SF水平,采用Pearson相关性分析ASD患儿血清5-HT与SF水平之间以及与CARS评分的关系,使用Logistic回归分析重度ASD发生的影响因素,并通过受试者工作特征(ROC)曲线分析血清5-HT、SF表达水平对重度ASD患儿的诊断价值。结果两组睡眠障碍、运动障碍和语言障碍比较,差异均有统计学意义(P<0.05)。研究组血清5-HT水平低于对照组(P<0.001),血清SF水平高于对照组(P<0.001)。研究组血清5-HT水平与SF水平呈负相关(P<0.01)。轻中度组5-HT水平高于重度组(P<0.01),轻中度组SF表达水平低于重度组(P<0.001);轻中度组的睡眠障碍、运动障碍和语言障碍比例低于重度组(P<0.05)。研究组血清5-HT水平与CARS评分呈负相关(P<0.01),SF水平与CARS评分呈正相关(P<0.001)。回归分析结果显示,睡眠障碍、运动障碍、语言障碍及血清SF水平为重度ASD发生的独立危险因素,5-HT为重度ASD发生的独立保护因素(P<0.05)。ROC曲线分析结果表示,血清5-HT和SF水平诊断重度ASD的曲线下面积为0.714和0.722,二者联合诊断重度ASD的曲线下面积为0.877,高于两者单独检测(P<0.05)。结论ASD患儿血清5-HT水平明显降低,SF水平明显升高,且均与ASD不同病情严重程度密切相关,两者联合检测对诊断ASD不同病情程度有重要意义。Objective To analyze the serum levels of 5-hydroxytryptamine(5-HT)and serum ferritin(SF)in children with autism spectrum disorder(ASD)and their correlation with the severity of illness.Methods A total of 82 children with ASD were selected as study group,while 34 healthy children who underwent physical examinations were included as control group.According to the Childhood Autism Rating Scale(CARS)score,82 children with ASD were divided into a mild to moderate group(30~35 points,45 cases)and a severe group(≥36 points,37 cases).Enzyme linked immunosorbent assay(ELISA)was applied to detect serum levels of 5-HT and SF in two groups.Pearson correlation was applied to analyze the correlation between serum 5-HT and SF levels,as well as the relationship between serum 5-HT and SF levels and CARS score in children with ASD.Logistic regression was applied to analyze the influencing factors of severe ASD.ROC curve was applied to analyze the diagnostic value of serum 5-HT and SF levels in children with severe ASD.Results The comparison of clinical features showed there were obvious differences in movement,sleep and language disorders between the two groups(P<0.05).The serum 5-HT level in study group was lower than that in control group(P<0.001),while the SF level was higher than that in control group(P<0.001).The serum 5-HT level in study group was negatively correlated with SF level(P<0.01).The 5-HT level of mild to moderate group was higher than that in severe group(P<0.01),and the SF level was lower than that in severe group(P<0.001).The proportions of movement,sleep and language disorders in mild to moderate group were lower than those in severe group(P<0.05).The serum 5-HT level in study group was negatively correlated with CARS score(P<0.01),while the serum SF level was positively correlated with CARS score(P<0.001).Logistic regression analysis showed that sleep disorder,movement disorder,language disorder,5-HT,and SF were all influencing factors for the severe ASD(P<0.05).ROC curve analysis indicated that the area und

关 键 词：孤独症谱系障碍 5-羟色胺 血清铁蛋白 病情严重程度 

分 类 号：R749.94[医药卫生—神经病学与精神病学]